Transcript Cartilage
Institute of Anatomy @ PMU Salzburg
Paracelsus Medical University | Strubergasse 21, A-5020 Salzburg | www.pmu.ac.at
Team at the Institute of Anatomy
Prof. Felix Eckstein, MD
Martin Hudelmaier, MD
Anja Ruhdorfer, MD, PhD
Sebastian Cotofana, MD
Torben Dannhauer, PhD
Wolfgang Wirth, PhD
Chondrometrics GmbH
Founded in 2003
CEO: Prof. Felix Eckstein
Provides quantitative cartilage analyses for industry & academia
Overlap of people between PMU & CHM
Institute of Anatomy
Research focus:
» Knee osteoarthritis
» Structural changes of cartilage and surrounding tissues
» Morphometric analyses
Portfolio
Morphometric analyses
» Usually MRI-based
» Manual or semi-automated segmentation
» Dedicated software
Cartilage
Meniscus
Thigh muscles
Portfolio: Cartilage
Measurement of:
» Cartilage thickness
» Cartilage volume
» Cartilage areas (subchondral bone area/
cartilage surface area)
P TrF
pLF
cLF
High-resolution, high-field MRI
Manual segmentation with quality control
readings
cLF
LT
cMF
LT
MT
cMF
cLF
MT
LT
Portfolio: Cartilage composition
Measurement of T2 (spin-spin) relaxation time
Multi-echo spin-echo MRI
Spin-spin relaxation time in cartilage:
» Collagen content
» Collagen orientation
» Water content
Manual segmentation with QC readings
19.4 ms
38.8 ms
58.2 ms
Portfolio: Meniscus
Measurement of:
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3D meniscus extrusion
3D meniscus morphology
Tibia plateau coverage
Regional analysis
Manual segmentation with QC readings
Portfolio: Muscle
Measurement of:
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3D thigh muscle volume
2D anatomical cross-sectional areas (ACSA)
Inter-muscular tissue
Subcutaneous fat
Femoral medulla & corticalis
T1 weighted spin-echo MRI
Manual / semi-automated segmentation
Osteoarthritis Initiative (OAI)
Longitudinal multi-center study (8 years)
4796 Participants (45-79 years at baseline)
Data and image assessments publicly available
Focus:
» Identification and evaluation of risk factors for incidence / progression of knee OA
» Validation of imaging biomarkers
http://www.oai.epi-ucsf.org
OAI: Available assessments
Assessments:
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Isometric strength
Physical activity scores
Alignment measurements (full-limb x-rays, knee x-rays)
Physical performance examinations
Knee examination (Joint laxity, …)
Semi-quantitative KLG, JSN, osteophyte readings
Radiographic joint space width
MRI-based cartilage thickness, meniscus, muscle measurements
Questionnaires:
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Pain (severity, frequency)
Function
Quality of Life
Medication
Nutrition
Occupation
…
OAI Thigh MRI
Acquisition started 100mm proximal to the distal epiphyseal line
Covers 15 slices (5mm slice thickness)
T1-weighted spin-echo MRI
Computation of comparable slices between subjects required
Specific strength (strength / ACSA)
Muscle groups
• Quadriceps
• Hamstrings
• Adductors
• Sartorius
Quadriceps heads
• Vastus medialis
• Vastus intermedius
• Vastus lateralis
• Rectus femors
ESR10: Muscle morphology and osteoarthritis
disease progression
Objectives:
» To identify the role of muscle tissue characteristics in predicting OA joint damage
» To assess the impact of joint biomechanics on this relationship
Profile:
» Background: Engineering / computer science ?
» 2 years+ PhD program (doctorate of medical sciences)
» KneeMo funding: 3 years
Project:
» Automation of the segmentation of muscle ACSAs
» Quantitative analysis of muscle ACSAs in OAI participants with and without
progressive cartilage thickness loss
ESR10: Muscle morphology and osteoarthritis
disease progression
Cohort selected by the OAI coordinating center (n=445 with Y4 FU)
KLG 2/3 knees (established radiographic OA)
BL
Y1
Cartilage thickness
Y2
Y3
Y4
Non-progressors
Cartilage thickness
Progressors
Muscle ACSA
Muscle ACSA
» Comparison of change in muscle ACSAs between participants with and without
severe cartilage loss (matched cases & controls)
» Combination with other assessments (e.g. alignment, knee injuries, joint laxity,
meniscus surgery)
ER3: Predicting OA outcome through muscle tissue
characteristics
Objective: To establish the predictive value of structural and
physiological factors on outcome in KOA
Profile:
» Background: Life sciences
» KneeMo funding: 2 years
Project:
» Quantitative analysis of muscle ACSAs in OAI participants, that
underwent total knee replacement surgery
» Case-control study with up to 4 years prior to surgery (n=222+)
» Available assessments:
• Cartilage thickness measurements
• Meniscus measurements
• Semi-quantitative MRI readings (cartilage lesions, ligaments,
bone-marrow lesions, …)
ER3: Predicting OA outcome through muscle tissue
characteristics
Cohort selected as part of the OAI POMA project (Kwoh & Hunter)
Knees with confirmed knee replacement surgery
Y2
Y3
Y4
BL
Y1
T-3
T-2
T-1
T-4
T-3
T-2
T-1
T-5
T-4
T-3
T-2
T-1
T-6
T-5
T-4
T-3
T-2
Y5
Y6
T0
T0
T0
T-1
T0
Y7
Exchange
Anatomy training
» Lectures
» Dissection course
Quantitative image analysis
» Background (MRI)
» Techniques
Small projects?
» Based on data from the OAI
» Quantitative analysis of a small cohort
Anatomy training
NanoDiaRa project meeting